Urinary System Flashcards
the kidneys are located in the
retroperitoneum
The urinary system comprises of:
kidneys - 2
ureters - 2
urinary bladder - 1
urethra - 1
How big are the kidneys
9-12 cm long
5 cm wide
2.5cm thick
Renal hilum
vertical indentation on the medial surface of each kidney where the renal artery enters and the ureters, renal vein and lymphatics exit
gerota fascia
renal fascia
layer of connective tissue encapsulating the kidneys
3 layers of tissue surrounds the kidneys
- inner - true capsule
- perinephric fat
- perinephric fascia - Gerota fascia
Anterior to R. Kidney
right adrenal gland
liver
morison’s pouch
duodenum
right colic flexure
anterior to L. kidney
left adrenal gland
spleen
stomach
panc
left colic flexure and coils of jejunum
posterior R. kidney
diaphragm
costodiaphragmatic recess of the pleura
12th rib
psoas muscle
quadratus lumborum
transversus abdominis muscle
functional unit of kidney
nephron
Kidney cortex
outer region of the kidney
one million blood filtering nephrons
darker than medulla - blood perfusion
glomerulus and convoluted tubules
kidney medulla
inner region of the kidney
renal pyramids separated by renal columns
kidney pelvis
basin-like area
major calyces - collect urine from nephrons
upper end of ureter
role of nephron
functional unit of kidney
filter blood and produce urine
renal pelvis - major calyces - minor calyces - renal papilla - renal pyramids
2 main structures of nephron
renal corpuscle
renal tubule
renal corpuscle
network of capillaries (glomerulus) surrounded by a bowman’s capsule
located in renal cortex
afferent arteriole
connects the renal arter to the glomerular capillary network
flows into the glomerulus
controls blood pressure
efferent arteriole
carry filtered blood from the glomerulus to the peritubular capillaries that surround the renal tubule
renal tubule
part of nephron that leads away from the glomerulus
-proximal convoluted tubule
-loop of henle
- distal convoluted tubules
proximal convoluted tubule
resorption of sugar, sodium and chloride ions, water from the glomerular filtrate
loop of henle
only part that dips in the medullary pyramids
keeping a concentration gradiant to reabsorb sodium and water from filtrate
distal convoluted tubules
cells that line it are able to pump harmful substances from the blood to urine
arterial supply
Renal artery off the AO
Anterior artery & Posterior artery
Segmental arteries
Interlobal arteries
Arcuate arteries
Interlobular arteries
(afferent arterioles, glomerulus, efferent arterioles)
venous drainage
interlobular veins
arcuate veins
interlobar veins
segmental veins
anterior & posterior veins
main renal vein drain into IVC
which vein travels transversely across the body, anterior to AO and posterior to SMA
left renal vein
lymphatic vessels follow
the renal artery to the lateral AO lymph nodes near the origin of the renal artery
ureter
bilateral tubes, 8-10 inches long
carry urine from kidneys to the bladder
Where do the ureters enter the bladder?
posteriorly
ureteropelvic junction
junction between the pelvis and the ureters
ureterovesical junction
between the ureter and the bladder
what muscle controls bladder flow
detrusor muscle
Where is the first site of filtration in the kidneys?
bowmans capsule
glomerular filtration - filtration
tubular reabsorption - reabsorption
tubular secreation - removes additional wastes
4 things you should never see in urine
biliruben
sugar
ketones
blood
normal variants of kidney
column of bertin
dromedary hump
junctional parenchymal defect
fetal lobulation
sinus lipomatosis
extrarenal pelvis
Indications for a renal ultrasound
abnormal lab values
flank pain
hematuria
pyuria
fever
palpable mass in the area of the kidney
hx of kidney stones or renal issues
incontinence
incomplete emptying of the bladder
frequent urination
what are the 3 processes in the formation of urine
- glomerular filtration
- tubular reabsorption
- tubular secretion
main metabolic waste products
water, co2, nitrogenous wastes (urea, uric acid, creatinine)
Ammonia is chemically converted to?
urea
what is formed from the breakdown of nucleic acids?
uric acid
column of bertin
invaginations of the cortex at varying depths within the medullary substance
may be difficult to differentiate from an avascular renal neoplasm
dromedary hump
shape of left kidney is affected by spleen
bulge of corical tissue can occur on the lateral border of the kidney
resemble a renal neoplasm
fetal lobulation
indented in between the calyces, lobulated appearance
children up to 5 yrs old
persist in up to 51% adults
junctional parenchymal defect
triangular, echogenic area typically located anteriorly and superiorly
stricture
ureteral narrowing that may be a result of
fibrosis (most common)
infammatory disease
TB
localized periureteral fibrosis
ureteral stone
ureterocele
cystlike enlargement of the lower end of the ureter caused by:
congenital stenosis
acquired stenosis
normal sonographic appearance of kidneys
smooth outer contour
cortex is hypoechoic to renal sinus/isoechoic to liver
widest/longest (1sag, 2 trv)
normal sonographic appearance of kidneys
distended and free of echoes
wall = 3-6mm
